In recent years, an increasing number of healthcare providers have initiated outpatient or health management programs for their patients. The potential benefits of these home-based self-care programs are particularly great for chronically ill patients, such as those suffering from diabetes or asthma, who must treat their diseases on a daily basis. However, the success of these home self-care programs is currently limited by each patient's initiative and motivation to comply with a prescribed treatment plan for his or her disease.
The most common reason a patient fails to comply with a treatment plan is a lack of motivation to treat the disease when the disease is not causing an immediately recognizable effect. The expected effect of most diseases is pain or discomfort, and once the pain or discomfort stop, many patients ignore the disease. Of course, most healthcare issues can be addressed more effectively through prevention. The challenge is in communicating the preventative concept to a patient in such a way that he or she will be motivated and encouraged to comply with a prescribed treatment plan.
A patient's lack of motivation to comply with a treatment plan also limits the ability of a healthcare provider to aid the patient in treating his or her disease. Many treatment plans require daily monitoring of a physiological condition of the patient, such as blood glucose concentration in diabetes, peak flow rates in asthma, and blood pressure in hypertension. Since the patients themselves monitor their conditions in outpatient programs, the healthcare provider is often limited to learning each patient's status strictly through patient-initiated events, whether an emergency visit or a phone call to tell the provider the patient's latest medical data. Even with the current availability of remote monitoring devices that store and transmit medical data from a patient's home to a medical clinic, the provider must still wait for medical information whose arrival depends on the patient's initiative.
As a result, the majority of the provider's time when caring for patients with chronic medical conditions is spent with the patients who are the most motivated and eager for treatment, while the greatest medical needs remain with the less motivated patients who do not visit the provider or transmit their medical data. These less motivated patients often develop urgent medical needs that could have been prevented with proper compliance with their prescribed treatment regimens. Consequently, the cost of treating their diseases is much higher than one might expect given the sophistication of current medical monitoring devices
Interactive home healthcare monitoring systems are described in U.S. Pat. No. 5,390,238 issued to Kirk et al. on Feb. 14, 1995, U.S. Pat. No. 5,434,611 issued to Tamura on Jul. 18, 1995, and U.S. Pat. No. 5,441,047 issued to David et al. on Aug. 15, 1995. One disadvantage of these systems is that they either require a patient to call in to a central facility to be monitored or require the central facility to call the patient according to a rigid monitoring schedule. In addition, these monitoring systems do not provide a patient with any incentives. As such, it is unlikely a patient will make use of them regularly.
U.S. Pat. No. 5,488,423 by Walkingshaw describes a home communication apparatus which prints out rewards or coupons in consumer categories which the user prefers. U.S. Pat. No. 5,502,636 by Clarke describes a personalized coupon generating and processing system which gives users coupons based on their consumer profiles. U.S. Pat. No. 5,504,519 by Remillard describes a method and apparatus for printing coupons which allows a user to select the coupons or other printed information he or she wants. The chosen coupons or information are printed at a central facility and then sent to the user. These inventions do not include any sort of health management program as the reason for receiving the coupons, however.
Home-based computerized reward systems are also described in U.S. Pat. Nos. 5,034,807, 5,128,752, 5,227,874, and 5,249,044 by Von Kohorn. These inventions taken together describe a system and method for evaluating a user's responses to broadcast programs. The programs are broadcast to a wide, undefined audience of users. Users can then enter in their responses to the broadcast programs via a keyboard or other response transmitting device. The user's responses are then transmitted to the response receiving station. A reward, such as a coupon, can be printed for the user from a printer located in the user's home.
This invention does not teach the modification of health-related behavior. Even in combination with health monitoring systems, this invention cannot be effectively used for healthcare programs because it is not individualized for different patients having different diseases or conditions. One broadcast program is sent at one time to all users who have the ability to receive the program. Thus a user who has diabetes would receive the same broadcast program as a user who needs to lose weight. In addition, the broadcast programs are difficult to customize to the individual viewer. For example, one diabetes program would be shown to all diabetics, without regard to their different needs. Although a number of broadcast programs could be created in order to accommodate all possible users, it would be prohibitively expensive and unwieldy. It would be much more efficient to have a dynamic program which could be adjusted for each particular user. Finally, in this invention, the transmitting station determines when the programs are broadcast, which is inconvenient to the user. It is much more convenient for the user to be able to view and/or hear a program when he or she wants.